Pursuit of Perfection: Signs of Muscle Dysmorphia

Body image — how we perceive ourselves — affects everyone at some point. While it is normal to have concerns about our appearance, some individuals experience intense anxiety and negative feelings that drive them to take extreme measures to change their bodies. When people become profoundly dissatisfied with their bodies and engage in obsessive, harmful behaviors to enhance their muscle size, they may be suffering from muscle dysmorphia.

What exactly is muscle dysmorphia? Who does muscle dysmorphia affect? What are the signs of muscle dysmorphia? What are some muscle dysmorphia symptoms?

Understanding Muscle Dysmorphia: A Struggle with Body Image

Muscle dysmorphia is a specific type of body dysmorphic disorder (BDD), a mental health condition characterized by an intense preoccupation with perceived flaws in one’s physical appearance. Often, these perceived imperfections are minor or even nonexistent.¹

Individuals with muscle dysmorphia have a distorted perception of their physique, feeling dissatisfied with the size or shape of their muscles. They may perceive themselves as too small or weak despite being leaner and more muscular than average. This thought process leads to an obsessive focus on exercise and dieting, relentlessly pursuing the “perfect” body. Muscle dysmorphia is also known as bigorexia or reverse anorexia — and sometimes Adonis complex — and poses significant risks to both physical and mental health.

Who does muscle dysmorphia affect?

Bigorexia is often viewed as a male issue — or male muscle dysmorphia — and while it primarily affects males, it can also affect females. The disorder typically emerges during adolescence or early adulthood, though it can develop later. Muscle dysmorphia transcends demographics, impacting individuals from diverse backgrounds, including various socioeconomic statuses, educational levels, ethnicities, and sexual orientations.²

Contributing factors

The exact causes of BDD and muscle dysmorphia are complex. Several contributing factors may include:³

• Chemical imbalances in the brain
• Family history of mental health conditions such as BDD or obsessive-compulsive disorder (OCD)
• Self-esteem issues such as low self-esteem and perfectionism
• Adverse childhood experiences such as trauma, abuse, or bullying
• Societal influences that include pressures from societal standards and social media

Understanding muscle dysmorphia is the first step toward seeking help. If you or someone you know is struggling with these issues, Aster Springs is here to support you in your journey to recovery.

Signs and Symptoms of Muscle Dysmorphia 

Muscle dysmorphia is marked by persistent unhappiness with one’s muscle size and leads individuals to engage in behaviors aimed at increasing muscle mass and reducing body fat. Key signs that someone may be suffering from muscle dysmorphia include:

• Excessive training: Spending excessive hours in the gym, often at the expense of other activities.
• Ignoring pain: Continuing to exercise despite injuries, pain, or exhaustion
• Strict dieting: Rigid dietary practices, such as meticulous calorie counting and obsession with nutrient ratios
• Body fat obsession: Preoccupation with body fat percentage
• Excessive supplement use: Taking an overwhelming amount of dietary supplements
• Clothing choices: Wearing clothes that either conceal perceived flaws or highlight muscularity
• Use of anabolic steroids: Reliance on steroids or performance-enhancing drugs to boost muscle growth
• Cosmetic procedures: Seeking plastic surgery or other cosmetic enhancements for muscle appearance
• Neglecting relationships: Prioritizing muscle building over personal relationships, work, or financial responsibilities
• Feelings of weakness: Perceptions of being weak or physically inadequate, regardless of muscle mass.
• Mirror behavior: Engaging in body checking in mirrors or reflective surfaces, or, conversely, avoiding mirrors altogether
• Low self-esteem: Struggling with feelings of low self-worth, insecurity, and shame
• Social anxiety and isolation: Withdrawing from friends and family due to body image concerns or obsessive workout and diet routines²

Side Effects and Risk Factors of Muscle Dysmorphia

The impact of muscle dysmorphia extends far beyond physical appearance, affecting both body and mind.

Physical consequences

Individuals may face severe physical and mental exhaustion, along with injuries to muscles, tendons, and joints. In extreme cases, muscle dysmorphia can lead to permanent organ damage. Those who use supplements — especially those containing synthetic hormones — are at heightened risk for liver and kidney damage, as well as severe cardiovascular issues like heart attacks, strokes, and blood clots.⁴

Psychological toll

On the mental health front, individuals often experience overwhelming feelings of shame and worthlessness. No matter how much effort they put into their workouts, they are never satisfied with the results. This destructive mindset can lead to depression, anxiety, and even suicidal thoughts.²

Risk of eating disorders

The obsession with body image that goes along with muscle dysmorphia can also trigger eating disorders. Many symptoms and behaviors of bigorexia mirror those found in eating disorders, leading to harmful eating patterns. Over time, this can develop into full-blown eating disorders such as anorexia or bulimia.⁵

Co-occurring mental health issues

Individuals suffering from muscle dysmorphia are also at risk for other mental health issues. Psychological disorders that commonly co-occur with muscle dysmorphia include:

• Mood disorders
• Anxiety disorders
• Obsessive-compulsive disorder (OCD)
• Substance use disorder (SUD)
• Attention/deficit hyperactivity disorder (ADHD)²

Life disruption

Ultimately, muscle dysmorphia takes a toll on every facet of life. Individuals affected often sacrifice their careers, financial stability, relationships, and social interactions — all in pursuit of an unattainable ideal of muscularity and leanness.

Treatments for Muscle Dysmorphia

Many individuals with muscle dysmorphia, or bigorexia, may not recognize their condition as a problem and may resist seeking help. However, this serious mental health issue requires professional treatment. It’s crucial to find a healthcare provider who specializes in muscle dysmorphia and related disorders.

Effective treatment solutions

Treatment typically combines psychotherapy with medication management. Cognitive behavioral therapy (CBT) is a highly effective form of psychotherapy for addressing bigorexia. CBT helps patients challenge negative self-talk and harmful thought patterns while also identifying compulsive behaviors and promoting healthier alternatives in their place. Additionally, antidepressants — such as selective serotonin reuptake inhibitors (SSRIs) — can also be beneficial in managing symptoms and treating muscle dysmorphia.³

Finding hope at Aster Springs

At Aster Springs, our experienced team collaborates with each client to create a personalized treatment plan tailored to their specific needs and any underlying issues contributing to their diagnosis. This collaborative approach increases the chances of lasting recovery. 

If you are ready to take the next step in the eating disorder recovery process for you or your loved one, the compassionate team at Aster Springs is here to help. Call us or fill out the online contact form today to begin your journey to recovery.

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References
¹ National Health Service. (October 2023). Body dysmorphic disorder (BDD).
² Olivardia, R., Blashill, A., & Hoffman, J. (2023). Muscle Dysmorphia. BDD.
³ Lovering, N. (January 2024). What to know about muscle dysmorphia. Medical News Today.
⁴ US Food & Drug Administration. (May 2022). Caution: Body building products can be risky.
5 Grant, J. E., & Phillips, K. A. (2004). Is anorexia nervosa a subtype of body dysmorphic disorder? Probably not, but read on… Harvard Review of Psychiatry, 12 (2), 123-6.